Objective To analyze the morbidity rate and clinical etiology distribution of secondary thrombocytosis(ST ) in chil‐dren in order to guide the clinical treatment .Methods The clinical data of 170 children patients with ST in hospitals were retro‐spectively analyzed for investigating its etiology distribution ,total morbidity and onset situation in different age periods . Results The primary etiologies of ST mainly included the infectious diseases(especially respiratory tract) ,anemia ,immune disea‐ses ,drugs ,surgical disease ,etc .Thrombocytosis caused by neonatal diseases also were common .The total morbidity rates of ST in children was about 3 .37% and which in newborns ,infants and children aged over 3 years were 2 .48% ,3 .78% and 1 .99% respec‐tively ,the difference was statistically significant(P<0 .5) .Conclusion ST is one of the common complications in children ,especial‐ly in children aged under 3 years old .The etiology of ST is various ,which are dominated by respiratory and digestive tract infec‐tions .Children aged under 3 years old ,especially infants and young children with respiratory tract infection are easier to suffer from complicating thrombocytosis .

Objective To explore the diagnostic value of the quantitative detection of miRNA-145 and miRNA-143 in the ser-um of children with Kawasaki disease (KD).Methods In this study,45 KD cases were enrolled and were divided into 19 ca-ses with coronary artery lesions (CAL group)and 26 cases without coronary artery lesions (NCAL group).Thirty healthy children were recruited as the control group (NC group).qRT-PCR was conducted to detect the expression of miRNA-145 and miRNA-143 in serum of each group.The diagnostic value of miRNA-145 and miRNA-143 were evaluated by receiver op-erating characteristic curves (ROC)and the area under the curve (AUC)(95%CI).Results The relative expressions of miRNA-145 and miRNA-143 in the serum of the CAL group in acute phase were 2.33±1.26 and 1.64±0.50,which were respectively higher than the control group,with statistically significant difference (t=5.108,5.072,P<0.01).The relative expression of miRNA-145 during the recovery phase of CAL group was 1.55±0.49,which was statistically significant high-er than NC group (t=3.837,P<0.01).While the relative expression of miRNA-143 during the recovery phase of CAL group was 1.17±0.33 and had no difference with NC group (t=1.033,P>0.05).During the acute phase of NCAL group, the relative expressions of miRNA-145 and miRNA-143 were 2.02±1.00 and 1.63±0.50 respectively.They were signifi-cantly higher than the control group (t=4.746,5.261,P<0.01).However,when comes to the recovery phase,the relative expression of miRNA-145 and miRNA-143 were 1.07±0.18 and 1.12±0.16,which had no difference with NC group (t=0.264 9,0.584 9,P>0.05).The critical value of miRNA-145 for diagnosis of KD was 1.697 with sensitivity of 64.44% and specificity of 90% and yielded an area under the curve of ROC of 0.7733 (95%CI:0.667 0~0.879 7).Also,the critical val-ue of miRNA-143 was 1.361 with sensitivity of 64.44% and specificity of 86.67% and yielded an area under the curve of ROC of 0.8163 (95%CI:0.722 5~0.910 0)in discriminating KD from healthy group.Conclusion miRNA-145 and miR-NA-143 may prove to be a non-invasive biomarker for the auxiliary diagnosis of KD.

Objective To explore the diagnostic value of the quantitative detection of plasma miRNA-125b and miRNA-133b in children with asthma.Methods Thirty asthmatic patients were enrolled in this study and collected the blood specimens during acute phase and stable phase respectively (AP group and SP group).Thirty allergic rhinitis children (AR group) and thirty healthy children were recruited to the control group (NC group).The levels of miRNA in different groups were detected by qRT-PCR.The performance of miRNA-125b and miRNA-133b were evaluated by receiver operating characteristic curves (ROC) and the area under the curve (AUC) (95％CI).Results The relative expression of miRNA-125b in AP group and SP group were significantly higher than A R group (t=3.913,3.120,P＜0.01),miRNA-133b.In AP group and AR group the expression of miRNA-133b were significantly higher than control group (t=4.426,4.720,P＜0.01).The detection of miRNA-125b yielded an area under the curve of ROC of 0.7989,(95 ％ CI:0.7111～ 0.8864) in discriminating asthmatic patients from healthy group.And the miRNA-133b was 0.7274 (95％CI:0.586 5～0.863 0) in discriminating asthmatic patients during the acute phase from healthy group.Conclusion The relative expression of miRNA-125b in children with asthma was significantly higher than that in AR group and NC group,miRNA-125b may prove to be a non-invasive biomarker for the auxiliary diagnosis of asthma especially when the relative expression up to 1.998.

OBJECTIVE: To investigate the effect of corticosteroids therapy on the inflammatory response in a critically ill coronavirus disease 2019 (COVID-19) patient. METHODS: A 55-year old female patient with critical ill COVID-19 was admitted in Taizhou Hospital on January 19, 2020. The patient was treated with methylprednisolone 80 mg on the 2nd day after admission. Thereafter, the dose was adjusted in a timely manner and the therapy lasted for 13 days. The peripheral lymphocyte subsets (CD3T, CD4 T, CD8 T, NK cells, B cells), as well as serum levels of lymphocyte factors (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ) were dynamically monitored. RESULTS: On D1 of admission, the numbers of peripheral blood CD3 T, CD4 T, CD8 T, and NK cells were significantly lower than the normal range. With the improvement of the disease, the numbers of CD3 T, CD8 T and CD4 T cells gradually recovered and showed a linear growth trend (linear fitting equation: =18.59+109.4, <0.05). On D2 of admission, the patient's IL-6 and IL-10 levels were significantly higher than normal values, IFN-γ was at a normal high value, and then rapidly decreased; IL-2, IL-4, and TNF-α were all in the normal range. On the D6 and D7, the IL-6 and IL-10 decreased to the normal range for the first time. On the D18, the sputum virus nucleic acid test was negative for the first time, and the fecal virus nucleic acid test was still positive; on the D20 the sputum and fecal virus nucleic acid test were both negative. On D34, the patient recovered and was discharged. At the discharge the muscle strength score of the patient was 44 and the daily life ability evaluation was 90. CONCLUSIONS In the absence of effective antiviral drugs, early use of appropriate doses of corticosteroids in critically ill patient with COVID-19 can quickly alleviate inflammatory response and improve clinical symptoms, however, it may reduce the number of T cells, and to adjust the dose in time is necessary.
Betacoronavirus ; isolation & purification ; Cell Count ; Coronavirus Infections ; diagnosis ; drug therapy ; immunology ; physiopathology ; Critical Illness ; Cytokines ; blood ; Female ; Humans ; Methylprednisolone ; administration & dosage ; adverse effects ; Middle Aged ; Pandemics ; Pneumonia, Viral ; diagnosis ; drug therapy ; immunology ; physiopathology ; T-Lymphocyte Subsets ; drug effects ; Treatment Outcome